加强医德建设 维护病人利益

加强医德建设　维护病人利益杨东秀加强医德建设，维护病人利益，就是要求医院在发展社会主义市场经济的新形势下，坚持办院宗旨，贯彻社会主义医德义务论、价值论、公益论，做到合理检查、合理用药、合理收费（下称“三论”、“三合理”），保证病人利益不受侵犯，为病人...     

质量和信誉是医院发展的源泉

一、适应供求关系变化,调整医疗服务结构 “疗效高、服务好、时间短、费用低”是病人对医院质量的永恒要求。市场经济越发展,科学文化越发达,生活水平越提高,病人对医院这种要求的相对期望值也越高,这是病人利益的根本所在。医院的宗旨是全心全意为人民服务,一切为病人是医院一切工作的出发点和目的。医院的利益和病人的利益是一致的,病人的需求也是医院的追求,质量和信誉正是医院利益和病人利益相一致的结合点。维护病人利益医院才有生命,损害病人利益,实际上也是在损害医院和员工的自身利益。医院要提高效益,必须走与病人利益相一致的道路,即以质量和信誉创造利益求发展。为此,必须按照病人和社区对医疗保健的需求,改进技术和服务,从“有什么,卖什么”转向“需要什么,供给什么”,按供求关系的变化,调整技术结构、专业结构、知识结构和服务     

浅谈医院内审对患者利益的维护

内部审计是国家审计体系的重要组成部分。在医院内它是在医院负责人直接领导下,根据国家的财经方针、政策和地方政府制定的有关规章制度,对医院财务收支的真实、合法性及效益实行内部审计监督。其作用分为保护性作用和建设性作用两个方面。就医院内部审计而言,有一个很重要的保护性作用就是对患者利益的维护。在医院服务模式由以医疗为中心转变为以病人为中心的今天,这种保护性作用对医院经营管理显得尤为重要。 所谓内部审计对患者利益的维护,就是通过严格收费制度和结算程序,促使医院费用的合理、合法、完整准确,制止     

美国医院维护病人权的概况及启示

病人的权利是指病人拥有的权利和享受的利益，是一个人台乎法律或俞平伦理的利益或要求。随着医疗事业的快速发展，病人权利的维护已成为全球关注的问题，有关病人权利的研究已成为国际化趋势。通过在美国医院的学习，深刻意识到美国医院完善的病人权利维护制度和有效的管理措施对高水平的医疗服务和良好的医患关系起到保障作用，对我国医院正在逐步完善的病人权利保障和管理制度有所启迪。     

强化服务思想意识 提高医院工作水平

1 强化服务思想意识,必须树立五种观念 (1)“极端尊重人的生命,一切为了病人”的观念。救死扶伤、治病救人是医务人员的天职,一切必须服从服务于病人病情的需要,一切对病人负责,把病人的利益放在第一位,特别要有高度的责任心,认真对待危重病人。只有树立这种观念,才符合医院的准则。 (2)“全方位优质服务”的观念。优质服务不是单一的,而是全方位的,每一个岗位、每一个环节都要优质服务。医院全体人员,从领导到职工,从     

强化医疗质量管理 全力维护患者利益

医疗质量是医院的生命线，质量管理是医院管理永恒的主题。我院在狠抓日常质量管理的同时，还对以下4个方面的工作进行了强化，全力维护患者利益。     

医院营销战略的理论与实践

在充满竞争的市场经济中，医院管理者要尽快树立营销管理观念，重视医院营销活动。要充分认识到：医院营销是通过创造服务，让患者和群体得到满足其需求和欲望的一个社会和管理过程，核心是追求患者满意，投其所好。根据患者价值原理、竞争优势原理、集中优势原理，在营销实践中，加速一是以病人为中心，向技术服务给病人带来利益为核心的转移。面向市场，制定总体战略：树立良好的形象，开展独树一帜的核心技术，提供超出患者预期、贴心、超值的服务；通过识别、建立、维护、巩固医院病人利益活动，占领市场，跟踪患者需求，进行资源整合，采取积极防御措施，扩大市场占有份额。以人为本，建立精简、扁平、具有弹性的营销组织，打造一支态度热忱、反应灵活、主动沟通、精力旺盛、知识广博、亲爱病人、不畏艰苦的营销队伍。在谋划实施营销战略中，要建设先进的医院文化，细分市场选择目标，进行资源整合，结构重组，选择竞争战略，分析营销环境，制定目标，建立评价激励机制。     

正确认识和处理医疗卫生改革中各种利益关系的思考

1 正确认识和处理医疗卫生改革中整体和局部利益的关系 1.1 关于卫生服务体系改革中的利益问题 城市卫生服务体系的改革,社区服务新模式的建立,相当一部分病人被分流,必然会影响到大医院的效益,面对这种利益上的矛盾,管理者一方面要充分认识到社区服务是发展方向,社区服务因地制宜、方便群众、优化卫生资源,符合中国国情;另一方面应该看到各级医院明确职能,大型医院集中优势,解决危重、疑难病症,搞好医学教育及科研,在技术水平的提高上下功夫,也有利于医     

医院营养食堂社会化与病人膳食管理

医院营养食堂是病人膳食的保障。营养食堂要实行社会化，必须以解决病人的膳食为前提，以不追求经济利益为基础，以切实为临床服务为宗旨，并建立与之相配套的管理机构及完善的质量管理监督制度，这样才能保持其专业功能，保证为病人提供安全、卫生、营养的膳食。     

完善麻醉协议书制度医疗纠纷防范于未然

麻醉协议书是医患之间重要的法律合同之一，为医患之间提供了法律保障依据。它既保护病人的健康和利益，也维护医院及麻醉医师的利益和信誉。为了减少和避免医患间不必要的医疗和法律纠纷，必须完善麻醉协议书制度，有效防范医疗纠纷。     

What We Say and What We Do: County-level Public Spending for Health Care

The purpose of this study is to examine county-level public spending for health care services in Kansas and to explain variation in spending levels with a model composed of population density, population age and per capita income. Data are abstracted from budget documents for all 105 counties in Kansas for the years 1994, 1995 and 1996. Health care expenditures are defined as county tax revenues spent for ambulance, hospitals, ambulatory care, home health services, nursing homes, and mental health and substance abuse services. Results show that Kansas counties spent between 12.1 percent and 13.6 percent of their budgets to fund local health care services between 1994 and 1996, spending more than $133 million in 1996 alone. In 10 counties, one-quarter to one-third of the budget went for health services. Low population density and relatively high per capita income explained nearly one-third of the variation in how much counties spent and an even greater proportion when analysis was limited to the most rural counties. Findings from this study suggest there may be a significant local commitment in the United States to publicly supported health care services, more support than typically recognized and perhaps more than is estimated in national health care spending data. Future research on the economic effects of the health sector on local communities should take account of local spending for health care, especially at the county level.     

What should a country spend on health care?

Per capita health spending across countries ranges by more than 100 to 1, leading many people to ask, "What should a country spend on health care?" This paper discusses four approaches to this question and demonstrates how each approach, in effect, answers a slightly different question, all of which are important to public policy decisions regarding health care spending. The paper also addresses a commonly cited World Health Organization statement that countries should spend 5 percent of national income on health care services.     

The impact of public spending on health: does money matter?

We use cross-national data to examine the impact of both public spending on health and non-health factors (economic, educational, cultural) in determining child (under-5) and infant mortality. There are two striking findings. First, the impact of public spending on health is quite small, with a coefficient that is typically both numerically small and statistically insignificant at conventional levels. Independent variation in public spending explains less than one-seventh of 1% of the observed differences in mortality across countries. The estimates imply that for a developing country at average income levels the actual public spending per child death averted is $50,000-100,000. This stands in marked contrast to the typical range of estimates of the cost effectiveness of medical interventions to avert the largest causes of child mortality in developing countries, which is $10-4000. We outline three possible explanations for this divergence of the actual and apparent potential of public spending. Second, whereas health spending is not a powerful determinant of mortality, 95% of cross-national variation in mortality can be explained by a country's income per capita, inequality of income distribution, extent of female education, level of ethnic fragmentation, and predominant religion.     

Getting what you pay for: public health spending and the performance of essential public health services.

Governmental spending in public health varies widely across communities, raising questions about how these differences may affect the availability of essential services and infrastructure. This study used data from local public health systems that participated in the National Public Health Performance Standards Program pilot tests between 1999 and 2001 to examine the association between public health spending and the performance of essential public health services. Results indicated that performance varies significantly with both local and federal spending levels, even after controlling for other system and community characteristics. Some public health services appear more sensitive to these expenditures than others, and all services appear more sensitive to local spending than to state or federal spending. These findings can assist public health decision makers in identifying public health financing priorities during periods of change in the resources available to support local public health infrastructure.     

北京市公立医院综合改革对医疗机构技术劳务收入的影响分析

目的:分析北京市医药分开和医耗联动综合改革对不同级别医疗机构体现医务人员技术劳务价值收入部分的影响。方法:利用参与北京市医药分开和医耗联动综合改革363家公立医疗机构2016年1月—2019年12月的监测数据,采用描述性分析结合多重间断时间序列模型,对改革前后不同级别医疗机构技术劳务收入及其占比的变化情况进行分析。结果:医药分开综合改革实施后,三级医院、二级医院、一级医院及社区的技术劳务收入较改革前分别增长了105.4%、119.7%和318.3%,其占比分别增长了5.91、6.44和5.87个百分点;医耗联动综合改革实施后,三级医院、二级医院、一级医院及社区技术劳务收入较改革前分别增长了26.2%、18.3%和11.6%,其占比分别增长了2.31、2.03和0.84个百分点。结论:北京市两项公立医院综合改革的实施有效促进了各级别医疗机构技术劳务收入的增长,医疗费用结构得到优化。建议进一步建立科学合理的医疗服务价格定价及动态调整机制,加强对基层医疗机构的重视,健全医疗服务行为监管体系。     

Who benefits from public health financing in Zimbabwe? Towards universal health coverage

Zimbabwe's public health financing model is mostly hospital-based. Financing generally follows the bigger and higher-level hospitals at the expense of smaller, lower-level ones. While this has tended to perpetuate inequalities, the pattern of healthcare services utilisation and benefits on different levels of care and across different socioeconomic groups remains unclear. The purpose of this study was therefore to assess the utilisation of healthcare services and benefits at different levels of care by different socioeconomic groups. We conducted secondary data analysis of the 2010 National Health Accounts survey, which had 7084 households made up of 26,392 individual observations. Results showed significant utilisation of health services by poorer households at the district level (concentration index of ?0.13 [CI:?0.2 to ?0.06; p?p?p?相似文献   

The impact of economic crisis on health-care consumption in Korea.

This study uses urban household income-expenditure survey data, national health insurance claims data, and public health centre surveys to examine the impact of economic crisis on the consumption of health services in Korea. The analysis shows that the health-care consumption of Korean households has been adversely affected by the recent economic crisis, as measured by amount of expenditure on health. Distributional implications for health sector use are also found. Whereas the use of medical services by upper income groups is only slightly affected by the economic crisis, lower income groups are spending relatively less on medical services. Of all households, unemployed households are hit hardest by the crisis. Analysis shows that for all households, the rate of expenditure decrease is relatively higher for drug expenditure than for expenditure on medical services. That is, facing declining income, people cut their spending in the area where the need is non-essential or less inevitable.     

Modelling the affordability and distributional implications of future health care financing options in South Africa

South Africa is considering introducing a universal health care system. A key concern for policy-makers and the general public is whether or not this reform is affordable. Modelling the resource and revenue generation requirements of alternative reform options is critical to inform decision-making. This paper considers three reform scenarios: universal coverage funded by increased allocations to health from general tax and additional dedicated taxes; an alternative reform option of extending private health insurance coverage to all formal sector workers and their dependents with the remainder using tax-funded services; and maintaining the status quo. Each scenario was modelled over a 15-year period using a spreadsheet model. Statistical analyses were also undertaken to evaluate the impact of options on the distribution of health care financing burden and benefits from using health services across socio-economic groups. Universal coverage would result in total health care spending levels equivalent to 8.6% of gross domestic product (GDP), which is comparable to current spending levels. It is lower than the status quo option (9.5% of GDP) and far lower than the option of expanding private insurance cover (over 13% of GDP). However, public funding of health services would have to increase substantially. Despite this, universal coverage would result in the most progressive financing system if the additional public funding requirements are generated through a surcharge on taxable income (but not if VAT is increased). The extended private insurance scheme option would be the least progressive and would impose a very high payment burden; total health care payments on average would be 10.7% of household consumption expenditure compared with the universal coverage (6.7%) and status quo (7.5%) options. The least pro-rich distribution of service benefits would be achieved under universal coverage. Universal coverage is affordable and would promote health system equity, but needs careful design to ensure its long-term sustainability.     

Health care financing in Kenya: a simulation of welfare effects of user fees

This paper examines the efficiency and equity effects of introducing user fees in public health facilities in Kenya. These effects are studied with the aid of a simulation technique. It is found that through their favourable effects on quality of medical services, the user fees in public clinics would yield welfare gains. However, these gains might involve unacceptable equity trade-offs. Thus, in general, the net welfare effects of user charges on medical services is ambiguous. More specifically, if the user fees were imposed across the board in government health facilities, the equity trade-offs would be large, and for that reason, the user fees would be socially and politically unacceptable. But, if the user charges are restricted to government hospitals, the attendant equity problem would not be too difficult to manage.     

Basic patterns in national health expenditure

Analysed in this paper are national health accounts estimates for 191 WHO Member States for 1997, using simple comparisons and linear regressions to describe spending on health and how it is financed. The data cover all sources - out-of-pocket spending, social insurance contributions, financing from government general revenues and voluntary and employment-related private insurance - classified according to their completeness and reliability. Total health spending rises from around 2-3% of gross domestic product (GDP) at low incomes (< 1000 US dollars per capita) to typically 8-9% at high incomes (> 7000 US dollars). Surprisingly, there is as much relative variation in the share for poor countries as for rich ones, and even more relative variation in amounts in US dollars. Poor countries and poor people that most need protection from financial catastrophe are the least protected by any form of prepayment or risk-sharing. At low incomes, out-of-pocket spending is high on average and varies from 20-80% of the total; at high incomes that share drops sharply and the variation narrows. Absolute out-of-pocket expenditure nonetheless increases with income. Public financing increases faster, and as a share of GDP, and converges at high incomes. Health takes an increasing share of total public expenditure as income rises, from 5-6% to around 10%. This is arguably the opposite of the relation between total health needs and need for public spending, for any given combination of services. Within public spending, there is no convergence in the type of finance - general revenue versus social insurance. Private insurance is usually insignificant except in some rich countries.